Case Report

Pulmonary mucormycosis in post-pulmonary tuberculosis as an emerging risk factor: A rare case report

Divya Khanduja* and Naveen Pandhi

Published: 30 July, 2021 | Volume 5 - Issue 1 | Pages: 059-063

Pulmonary mucormycosis is an uncommon pulmonary fungal disease, which is commonly seen in immunocompromised individuals. It is caused by fungi of class Zygomycetes. It constitutes the third most common invasive fungal infection following aspergillosis and candidiasis. Risk factors include patients with hematological malignancies, diabetes mellitus, and immunocompromised states. It is difficult to diagnose early due to non-specific clinical presentation and delay in treatment associated with greater mortality. As we know that Tuberculosis and HIV are highly prevalent in country like India. Post pulmonary tuberculosis is emerging as a risk factor for Pulmonary mucormycosis in the developing countries like India. Patients with non-resolving pneumonia are generally misdiagnosed as Pulmonary tuberculosis. The diagnosis of Pulmonary Mucormycosis is based upon demonstration of fungal hyphae in the clinical specimen. We highlight the importance of clinical suspicion in these cases for early diagnosis and early treatment initiation can reverse morbidity and mortality associated with Pulmonary Mucormycosis. We report 2 cases of Pulmonary mucormycosis present in post-pulmonary tuberculosis patients.

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Pulmonary mucormycosis; Tuberculosis; HIV; Air crescent sign


  1. Ribes JA, Vanover-Sams CL, Baker DJ. Zygomycetes in human disease. Clin Microbiol Rev. 2000; 13: 236–301. PubMed: https://pubmed.ncbi.nlm.nih.gov/10756000/
  2. Hibbett DS, Binder M, Bischoff JF, Blackwell M, Cannon PF, et al. A higher‑level phylogenetic classification of the Fungi. Mycol Res. 2007; 111: 509-547. PubMed: https://pubmed.ncbi.nlm.nih.gov/17572334/
  3. Spellberg B, Edwards J Jr, Ibrahim A. Novel perspectives on mucormycosis: Pathophysiology, presentation and management. Clin Microbiol Rev. 2005; 18: 556-569. PubMed: https://pubmed.ncbi.nlm.nih.gov/16020690/
  4. Fürbringer P. Observations on pulmonary mucormycosis in humans. Virchows Arch Path Anat. 1976; 66: 330-365.
  5. Prakash H, Chakrabarti A. Epidemiology of Mucormycosis in India. Microorganisms. 2021; 9: 523. PubMed: https://pubmed.ncbi.nlm.nih.gov/33806386/
  6. Prakash H, Chakrabarti A. Global Epidemiology of Mucormycosis. J Fungi (Basel). 2019; 5: 26. PubMed: https://pubmed.ncbi.nlm.nih.gov/30901907/
  7. Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, et al. Coronavirus Disease (Covid-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature. Mycopathologia. 2021; 186: 289-298. PubMed: https://pubmed.ncbi.nlm.nih.gov/33544266/
  8. Jeong W, Keighley C, Wolfe R, Lee WL, Slavin MA, et al. The epidemiology and clinical manifestations of mucormycosis: A systematic review and meta-analysis of case reports. Clin Microbiol Infect. 2019; 25: 26–34. PubMed: https://pubmed.ncbi.nlm.nih.gov/30036666/
  9. Prakash H, Ghosh AK, Rudramurthy SM, Singh P, Xess I, et al. A prospective multicenter study on mucormycosis in India: Epidemiology, diagnosis, and treatment. Med Mycol. 2019; 57: 395–402. PubMed: https://pubmed.ncbi.nlm.nih.gov/30085158/
  10. Skiada A, Pagano L, Groll A, Zimmerli S, Dupont B, et al. Zygomycosis in Europe: Analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect. 2011; 17: 1859–1867. PubMed: https://pubmed.ncbi.nlm.nih.gov/21199154/
  11. Serris F. Danion F, Lanternier F. Disease entities in mucormycosis. J Fungi. 2019; 5: 23. PubMed: https://pubmed.ncbi.nlm.nih.gov/30875744/
  12. Garg R, Marak RS, Verma SK, Singh J, Sanjay, et al. Pulmonary mucormycosis mimicking as pulmonary tuberculosis: a case report. Lung India. 2008; 25: 129–131. PubMed: https://pubmed.ncbi.nlm.nih.gov/20165666/
  13. Challa S, Uppin SG, Uppin MS, Paul RT, Prayaga AK, et al. Pulmonary zygomycosis: a clinicopathological study. Lung India. 2011; 28: 25–29. PubMed: https://pubmed.ncbi.nlm.nih.gov/21654982/
  14. Song JG, Kang SH, Jung BW, Oh HS, Kim MJ, et al. Invasive pulmonary aspergillosis histologically mimicking mucormycosis. The Ewha Med J. 2016; 39: 65–68.
  15. Donado‑Uña JR, Díaz‑Hellín V, López‑Encuentra A, Echave-Sustaeta JM. Persistent cavitations in pulmonary mucormycosis after apparently successful amphotericin B. Eur J Cardiothorac Surg. 2002; 21: 940-942. PubMed: https://pubmed.ncbi.nlm.nih.gov/12062298/
  16. Chung JH, Godwin JD, Chien JW, Pipavath SJ. Case 160: Pulmonary mucormycosis. Radiology. 2010; 256: 667-670. PubMed: https://pubmed.ncbi.nlm.nih.gov/20656848/
  17. Al‑Abbadi MA, Russo K, Wilkinson EJ. Pulmonary mucormycosis diagnosed by bronchoalveolar lavage: A case report and review of the literature. Pediatr Pulmonol. 1997; 23: 222-225. PubMed: https://pubmed.ncbi.nlm.nih.gov/9094732/
  18. Tedder M, Spratt JA, Anstadt MP, Hegde SS, Tedder SD, et al. Pulmonary mucormycosis: results of medical and surgical therapy. Ann Thorac Surg. 1994; 57: 1044–1050. PubMed: https://pubmed.ncbi.nlm.nih.gov/8166512/
  19. Cornely OA, Alastruey-Izquierdo A, Arenz D, Chen SCA, Dannaoui E, et al. Global guideline for the diagnosis and management of mucormycosis: An initiative of the European Confederation of Medical Mycology in cooperation with the Mycoses Study Group Education and Research Consortium. Lancet Infect Dis. 2019; 19: e405–e421. PubMed: https://pubmed.ncbi.nlm.nih.gov/31699664/


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